Human leukocyte antigen-DR mismatch is associated with increased in-hospital mortality after a heart transplant

Valeria Crudele, Francesco Cacciatore, Vincenzo Grimaldi, Ciro Maiello, Giampaolo Romano, Cristiano Amarelli, Antonietta Picascia, Pasquale Abete, Claudio Napoli

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Although previous studies have investigated the effect of human leukocyte antigen matching on long-term outcomes after heart transplants, its role in the prognosis after a heart transplant remains unclear, particularly with respect to short-term survival. Materials and Methods: We evaluated the human leukocyte antigen mismatch on in-hospital mortality of 158 consecutive patients who had undergone a heart transplant between 2000 and 2008. Human leukocyte antigens-A, -B, and -DR were determined by means of serologic and molecular techniques. Univariate analysis and a multiple logistic regression models evaluated the effect of human leukocyte antigen variants on mortality, independent of clinical variables. Results: In-hospital mortality was 11.4%. Higher prevalence of acute kidney injury (50.0% vs 12.9%), higher levels of troponins 48 hours after transplant (15.6 ± 12.0 ng/mL vs 9.7 ± 9.4 ng/mL), prolonged ischemia (188.2 ± 32.5 min vs 162.6 ± 40.7 min), higher frequency of reoperation (61.1% vs 17.9%), and higher human leukocyte antigen-DR mismatch (1.61 ± 0.5 vs 1.30 ± 0.6) were found in patients who died. By logistic regression analysis, humanleukocyte antigen-DR mismatch is associated with in-hospital mortality (OR-5.159, 95% CI-1.348-19.754), independent of the effect of covariates such as recipient age, mismatch sex, mismatch human leukocyte antigen-A, human leukocyte antigen-B, acute kidney injury, reoperation, ischemia duration, and levels of troponins. Conclusions: Human leukocyte antigen-DR mismatch is associated

Original languageEnglish
Pages (from-to)346-351
Number of pages6
JournalExperimental and Clinical Transplantation
Volume11
Issue number4
DOIs
Publication statusPublished - Aug 2013

Keywords

  • Heart transplant
  • HLA-DR mismatch
  • Human leukocyte antigen
  • Immunological compatibility
  • In-hospital mortality

ASJC Scopus subject areas

  • Transplantation

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